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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study

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Author(s):
Giovanna Lombardi Bonini Borges [1] ; Mayara Moura Alves da Cruz [2] ; Ana Laura Ricci-Vitor [3] ; Paula Fernanda da Silva [4] ; Sherry Lynn Grace ; Luiz Carlos Marques Vanderlei [6]
Total Authors: 6
Affiliation:
[1] Universidade Estadual Paulista. School of Technology and Sciences. Department of Physiotherapy - Brasil
[2] Universidade Estadual Paulista. School of Technology and Sciences. Department of Physiotherapy - Brasil
[3] Escola Superior de Saúde Egas Moniz. Egas Moniz - Cooperativa de Ensino Superior - Portugal
[4] Universidade Estadual Paulista. School of Technology and Sciences. Department of Physiotherapy - Brasil
[6] Universidade Estadual Paulista. School of Technology and Sciences. Department of Physiotherapy - Brasil
Total Affiliations: 6
Document type: Journal article
Source: São Paulo Medical Journal; v. 140, n. 1, p. 108-114, 2022-01-05.
Abstract

ABSTRACT BACKGROUND: Cardiac rehabilitation (CR) barriers are well-understood in high-resource settings. However, they are under-studied in low-resource settings, where access is even poorer and the context is significantly different, including two-tiered healthcare systems and greater socioeconomic challenges. OBJECTIVE: To investigate differences in characteristics of patients attending publicly versus privately funded CR and their barriers to adherence. DESIGN AND SETTING: Observational, cross-sectional study in public and private CR programs offered in Brazil. METHODS: Patients who had been attending CR for ≥ 3 months were recruited from one publicly and one privately funded CR program. They completed assessments regarding sociodemographic and clinical characteristics and the CR Barriers Scale. RESULTS: From the public program, 74 patients were recruited, and from the private, 100. Participants in the public program had significantly lower educational attainment (P < 0.001) and lower socioeconomic status (P < 0.001). Participants in the private program had more cognitive impairment (P = 0.015), and in the public program more anxiety (P = 0.001) and depressive symptoms (P = 0.008) than their counterparts. Total barriers among public CR participants were significantly higher than those among private CR participants (1.34 ± 0.26 versus 1.23 ± 0.15/5]; P = 0.003), as were scores on 3 out of 5 subscales, namely: comorbidities/functional status (P = 0.027), perceived need (P < 0.001) and access (P = 0.012). CONCLUSION: Publicly funded programs need to be tailored to meet their patients’ requirements, through consideration of educational and psychosocial matters, and be amenable to mitigation of patient barriers relating to presence of comorbidities and poorer health status. (AU)

FAPESP's process: 18/18276-6 - Acute autonomic responses of virtual reality based therapy in comparison with conventional cardiac rehabilitation
Grantee:Paula Fernanda da Silva
Support Opportunities: Scholarships in Brazil - Scientific Initiation